Prognostic factors for graft function in peadiatric kidney transplant

L. Oomen, L.L. de Wall, E.A.M. Cornelissen, W.F.J. Feitz, C.M.H.H.T Bootsma-Robroeks

Thursday 5 march 2020

13:30 - 13:40h at Leo Franssen zaal

Parallel session: Parallel sessie XIV– Klinische abstracts

Background: Graft survival in paediatric kidney transplant recipients has increased in the last decades. Determining prognostic factors for graft function over time allows the identification of patients that are at risk for graft loss and the improvement of current care guidelines.

Methods: Data were collected among paediatric kidney transplant recipients in a single centre during the first five years of follow-up. Mixed model analysis was used to indicate possible prognostic factors for the loss of graft function.

Results: A total of 100 paediatric kidney transplant recipients were analysed. Prognostics factors that were found to negatively influence graft function are a higher donor age and higher recipient age, an urological cause for end-stage renal disease (ESRD), re-transplant and occurrence of BK virus (BKV) infection. Patients with a steroid-sparing regimen had better graft function over time than those who used steroids. The influence of both donor age and having an urological cause of ESRD became stronger with time. In this study, the prognostic factors that do not influence graft function over time are the number of HLA-DR mismatches, pre-transplant dialysis, intra-abdominal graft placement, ischemia time, presence of lower urinary tract dysfunction, occurrence of urinary tract infections and infections with cytomegalovirus and Epstein-Barr virus.

Conclusions: This study revealed a higher donor age and higher recipient age, an urological cause for ESRD, a re-transplant and the occurrence of BKV infection to be negative prognostic factors for graft function over time in the first five years after transplant. Steroid sparing regimens appeared to be safe.